What is it with tech companies who know virtually nothing about healthcare (GoogleHealth and Microsoft HealthVault were awesome weren’t they?) who suddenly think they can build a better mousetrap? What makes them feel that they can take a seemingly carefree drive down an already well-travelled road littered with industry and government created potholes (interoperability and privacy regulations anyone?), thinking that some fancy graphics and slick functionality can smooth out the bumps? And what makes them think they can get people to use an App simply by slapping their household name on the wrapper?
Forgive our incredulity as we explore the much ballyhooed but less than overwhelming release of the latest version of Apple Health. Want to have a place to monitor and record your daily activities (steps, distance, and correlative heart rate) and spit back data to help you live a healthier lifestyle? Check. Want to store all that information and have a place to centrally aggregate your health records from various doctors and hospitals? They’ve got that too. Want to truly take control and begin managing your own health care, communicate, and share information with everyone responsible for helping to keep you healthy? Not so fast Mario.
VertitechIT Chief Medical Officer Dr. Neil Kudler is skeptical too, calling Apple Health a big fancy health system trial, error, failure. “Unless the entire proprietary nature of our economy becomes nationalized in the form of Apple-Google-Amazon, I don’t think Apple is going to do much more than gussy up the healthcare apps that generally only healthy and health-conscious people will use.” And Dr. Kudler should know, having previously served as a Chief Medical Information Officer for a major hospital system and as the Senior Healthcare Innovation Strategist for a leading technology incubator. “I’m not clear on what Apple is trying to do except to get its big bite of the healthcare GDP.”
In many ways, Apple Health is an electronic version of the clipboard you’re given when you visit a doctor’s office for the first time. Are you allergic to nuts? Do you smoke? What do you take for headaches? Enter your username and password from your physician’s portal and the information is downloaded to your cellphone. So now you have it. Unfortunately, Apple hasn’t figured out how you can share these records electronically with that specialist you’re going to see next week.
That would require Apple to wade into the murky waters of HIPAA, something the company is trying to avoid at all costs (although you can apparently share data with other healthcare apps). The company has been steadfast in its insistence that since you are downloading your electronic health records directly from your physician’s office to your encrypted iPhone and not to Apple-owned servers, privacy protections don’t apply. I guess using the App to then transfer that information to another third-party App is your business. Yikes!
It all comes down to this central point. Apple Health is a glorified patient portal that lacks the ability to do what your doctor’s portal does best; connect you to your physician in the most hassle-free way possible. Unlike most portals that allow for the back and forth free flow of information in a protected fashion, Apple Health is a one-way street. You’ll still need to use the doctor’s portal to ask a question about that blood test or request a refill on a prescription.
Which leads to the fundamental question; do we really need another App? Patient portal use is still quite low. Primary care physicians say they don’t see more than 35% of all patients electronically accessing their own records. And Dr. Kudler is quick to add that doctors don’t want another byte of data either. “Until and only if organizations are willing to invest the necessary dollars to build out new layers of care provision in the form of navigators, care coordinators and care managers won’t reap any of the benefit of these data-based innovations.”
To call Apple Health an abject failure would be unfair. History tells us that the first use of primitive electronic health record systems was in the early 1960s. We’ve come a long way in 50 years. But there is much work to be done and major obstacles to overcome. Until then, you may want to nibble at the apple before taking a big bite.